Usually couples come for infertility treatment first, because they have not been able to conceive naturally for a year. In such cases they wish go through the basic treatment options before they can go for the more radical option of Surrogacy. They undergo the usual process, which involves initial investigations to determining the cause or type of fertility. In some cases corrective surgery is required following which the couple can conceive through IUI or IVF. If wife is unable to produce healthy eggs then an egg donor is used and conception is achieved through donor IVF. A sperm donor may be required in cases of male infertility. Surrogacy is advised only when all other treatments options have failed.
In some medical conditions where Pregnancy is Contra- Indicative (uterus has been removed or ovarian/uterine cancer) it is clear from the start the Intended mother cannot conceive by IUI or IVF. In such conditions couples are advised to go for surrogacy directly.
ICMR guidelines have laid down strict criteria for intended parents who may be eligible for Surrogacy.
- Surrogacy should be advised only when all other ART treatment options have exhausted.
- The surrogate child should be genetically related to at least one of the Parents (Intended mother or father).
- Single individuals may apply for surrogacy however they should be able to contribute their gamete, i.e the child should be genetically related to the single parent.
- If both the Intended parents or Single Individual(s) applying for surrogacy are infertile and unable to provide reproductive cells, they are not eligible for surrogacy. Adoption is the only option available for them.
- Married Couples and Unmarried couples in live-in relationships are eligible for surrogacy. Same Sex Couples are not eligible.
Surrogacy is the usually recommended for:
- Women with advance age.
- Women with low ovarian reserve (AMH level).
- Women who are suffering from cancer.
- Women who have suffered repeated miscarriages and are deemed to have little or no chance of carrying a child to term.
- Women with disorders that prevent conception or causes miscarriage Eg: Women with Auto-Immune disorders, blood clotting disorders like Factor V Leiden etc.
- Women whose ovaries are producing eggs but they do not have uterus. Their uterus may have been removed (hysterectomy) or they were born without a uterus. This is the most common indication for IVF Surrogacy.
- Women who suffer from medical problems such as severe heart and kidney diseases, severe diabetes and in whom a pregnancy would be life threatening. However, their long term prospect for health is good.
- Repeated failure of treatment by IVF. Women who have never shown any signs of implanting normal embryos in an apparently normal uterus even after 5 to 6 IVF cycles.
- Women with congenital defects such as T- shaped uterus or hypoplastic uterus with a history of repetitive pregnancy loss. Women with severe untreatable adhesions inside uterine cavity (intrauterine synechia).
- Single men and woman who are fertile and wish to have children of their own using egg donor or sperm donor respectively.